Vaccination urged as Texas pertussis epidemic continues

Texas health officials are urging people to make sure they are vaccinated against pertussis -- the state has reported nearly 2,000 whooping cough cases to the CDC so far this year, and is expected to surpass the recent high of 3,358 cases in 2009.

“This is extremely concerning. If cases continue to be diagnosed at the current rate, we will see the most Texas cases since the 1950s," Lisa Cornelius, MD, a Texas Department of State Health Services (DSHS) infectious diseases medical officer, said in a press release. “Pertussis is highly infectious and can cause serious complications, especially in babies, so people should take it seriously.”

The state has reported two infant deaths in children too young to be vaccinated this year. The DSHS has issued a health alert advising clinicians on appropriate vaccination, treatment and post exposure prophylaxis, and has placed particular emphasis on vaccinating pregnant women, as well as fathers, siblings and anyone else likely to be around newborn infants.

"Check the vaccination history of all patients and offer vaccine to anyone that is not up-to-date," David Lakey, MD,
commissioner of the Texas DSHS wrote in Sept. 3 health alert. "Ensuring infants get the DTaP series on time and that pregnant women are vaccinated every pregnancy with Tdap can help prevent infant hospitalization and death."

Although the Tdap vaccine can be given at any time during pregnancy, the optimal timing for administering the vaccine is between 27 and 36 weeks gestation. Women who are not vaccinated during pregnancy should be given Tdap immediately postpartum.

Three doses of DTaP should be administered to children at 2, 4 and 6 months, and two booster doses should be given from 15 through 18 months and again at 4 through 5 years. Tdap should be given once every 10 years beginning at ages 11 through 12 years.

The CDC's catch-up immunization schedule provides more detailed instructions for those who have missed any of the doses in the DTaP or Tdap schedules.

Patients suspected of having pertussis should be advised to stay home from work, school, daycare or public outings until they have completed five days of appropriate antibiotic therapy, and Texas law requires healthcare providers report any pertussis cases to their local health department within one working day.

ClinicalAdvisor.com is for nurse practitioners and physician assistants, offering the latest information on diagnosing, treating, managing, and preventing medical conditions typically seen in the office-based primary-care setting.

Find all of the news and departments you love from the print issue archived for easy online access, along with special Web-only content.